Cannabis products provide long-term pain relief and greatly reduce the need for pharmaceutical interventions in patients with refractory lower back pain, according to observational data published in the European Spine Journal.
“These results add to the growing and compelling body of data indicating that cannabis is a clinically meaningful, opioid-sparing option for patients with various types of treatment-resistant pain conditions,” NORML’s Deputy Director Paul Armentano said.
Israeli researchers assessed the long-term efficacy of cannabis in over 600 patients diagnosed with treatment-resistant chronic lower back pain (CLBP). (Cannabis products are available by prescription in Israel.) Study participants had no prior experience with cannabis and had failed to respond to traditional prescription medications. Patients consumed either botanical cannabis (62 percent) or extracts (31 percent) during the study. Participants were assessed at baseline and annually for the following ten years.
Following cannabis treatment, patients experienced significant improvements in their pain and disability, while also substantially reducing their use of opioids and other prescription medications – a finding that is consistent with other studies. Specifically, patients’ daily opioid intake fell nearly 90 percent during the study. Participants also reported significant decreases in their use of SSRIs, gabapentin, benzodiazepines, and tramadol.
Patients generally did not escalate their cannabis intake over the 10-year period, indicating that they did not become tolerant to its therapeutic effects. No participants discontinued their use of cannabis due to adverse events or sought hospital treatment for any cannabis-related side effects. No patients met criteria consistent with cannabis use disorder.
“This 10-year observational study represents the longest follow-up of medical cannabis therapy specifically in CLBP patients,” the study’s authors concluded. “Medical cannabis therapy was associated with reductions in opioid use (− 89.8 percent), pain intensity (− 84.2 percent), and functional disability (− 30.4 percent), with high proportions of patients achieving pre-specified MCID [minimal clinically important difference] thresholds. Substantial polypharmacy reductions and acceptable tolerability were observed. … The magnitude and durability of these findings merit careful consideration in the context of existing evidence and current treatment paradigms for chronic low back pain.”
Data published in the Journal of the American Medical Association reports that nearly one in three patients with chronic pain use cannabis as an analgesic agent and many of those who do substitute it in place of opioids.
The full text of the study, “Ten-year outcomes of medical cannabis for chronic low back pain: opioid reduction, pain relief, and functional improvement in 1,000 patients,” is available in the European Spine Journal. Additional information is available from NORML Fact Sheet, ‘Relationship Between Marijuana and Opioids.’
